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General Neuro

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Created by: KelsM

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Question	Answer
UE flexion synergy pattern	scap elevation ad retraction shoulder abd and ER elbow flexion forearm supination wris/finger flexion
LE flexion synergy	hip flexion, abd, ER Knee flexion ankle DF/IV toe DF
Number of spinal nerves (how are they divided)	8 cervical 12 thoraicic 5 lumbar 5 sacral 1 coccygeal
Sympathetic and Parasympathetic Neurotransmitters	S: Norepinepherine P: Acetylcholine
Admoninal Reflex Level? Normal	T8-L1 abs contract deviate belly button in direction of stimulus
Corneal Blink reflex Normal nerves	Both eyes blink with stimulus of one Trigeminal facial
Cremasteric reflex normal nerve level	brisk and brief elevation of testical ipsi to stroke L1-2
Gag reflex nerves	glossopharangeal and vagus
Plantar reflex nerves & + normal	L5-S1 Babinski (toes flare) toes flex
REFLEX GRADING	0 no 1+ depressed 2+ normal 3+ exaggerated 4+ hyperactive
how to test superficial sensation	temperature light touch pain
how to test deep sensaiton	proprioception kinesthesia vibration
How to test corticcal sensation	B simultaneous stimulation stereognosis 2 pt discrimiantion barognosis localization of touch
what tuning fork Hz should be used	128Hz
Monofilament protective sensation
Barognosis	wt of differnet objects in hand
Graphesthesia	identify number of letter drawn on skin
Kinesthesia	identify direction and extent of movement of a joint or body part
Localization	identify exact spot being touched
proprioception	identify statically ehre limb is positoined
Stereognosis	identify object witout sight in hand
Superficial Pain	Perceive noxious stimulus using pen cap, paper clip end or pin
Two point discrimination	identify one or 2 points
Mono filament loss of protective sensation	5.07 (10 g)
Allodynia	sense pain in response to stimulus that would not normally produce pain
Analgesia	absent of pain while remaining consious
Anesthesia	absent of touch sensation
Causalgia	constant reelentless, burning hyperesthesia & hyperalgesia after peripheral nerve injury
Dysesthesia	disortion of any of senses (especially touch)
Hyperesthesia	heightened sensation
Hyperpathia	extreme exaggerated response to pain
Hypesthesia	diminished sesnation to touch
Neuralgia	sever and multiple shock like pains that radiate from a specific nerve distribution
pallanesthesia	loss of vibration sensation
paresthesia	abdnormal sensation (tingling, pins and needles burning)
Wallerian Degeneration	degeneration that occurs distally specifically to myelin sheath and axon
common cause of axillary nerve injury	fx of humerus ant dislocation of shoulder
common cuase of musculocutaneous injury	fx of clavicle
common cause of radial nerve injury	radial tunnel compression fx of humerus
common cause of median nerve injury	carpal tunnel protator teres entrapment
common cause of ulnar nerve injury	cubital tunnel entrapment of guyons canal
common cause of femorla nerve injury	arhtoplasty displaced acentabular fx ant dislocation of femure hysterectomy appendectomy
common cause of sciatic N injury	blunt force trauma to buttocks THA accidental injection to nerve
common cause of obturator N injury	fixation of femure fx THA
common cause of peroneal N inury	femur, tib, fib Fx positioning during surgical procedures
common cause of Tibial N injury	tarsal tunnel entrapment popliteal fossa compression
common cause of Sural N injury	calcaneous fx Laterall malleolus Fx
Agnosia	inability to recognize familiar objects w one form of sensation
Akinesia	inability to initiate movement
Aphasia	disturbance to language that results in errors in word choice, comprehension or syntax
Expressive or brocas aphasia	sever difficulty in verbal expression impairment in object naming and writing abilities (R hemi)
Global aphasia	most sever reduced speech and comprehension reading and writting impaired
Receptive or Wernickes aphasia	sever disturbance in auditory comprehension impaired reading, writing, word recognition
Apraxia	inability to perform movements previously learned even though no loss in strength, coordination, sensation or comprehension
ideational apraxia	doesn't get how to do task
ideomotor apraxia	can not do task on command but cna do it spontaneously
Astereogenosis	inability to recognize object by touch
asynergia	inability to move muscles together in a coordianted manner
Ataxia	uncoordianted movement (especially gait)
Athetosis	slow, involuntary, worm like twisting mtions (CP)
What is reflex sympathetic dustrophy now called?	Causalgia
Cheyne Stokes Respiration	bizaree breathing pattern periods of apnea 10-60 sec followed by gradually increasing then decreasing depth and frequency of respiration
Chorea	Rapid involuntary movements
Clonus	rhythmic oscillations of muscle n response to sustaind stretch in pt w UMN
Contraction of extensor muscles of UE and LE bc of injury at brain stem	decerebrate rigidity
Contraction of flexor muscles of UE and contraction of extnesor muscles of LE	Decorticate Rigidity
Delirium	temporary confusion and loss of mental function
Dementia	loss of memory or intellectual function
Dysmetria	inability to judge distance
virus of shingles	herpes Zoster
Horners syndrome S&S	P: ptosis (eye lid) A: agnosia (lack of sweating) ipsi face M: Myosis (pupil restriction)
If nerve is damaged how is velocity and latency affected	Velocity slowed latency increased
Nystagmus	rapid back and forth movement of eye balls
Somatagnosia	lack of awareness of relationship of ones own body parts or the body parts of others
vision alterantion from damage to optic tract	Homonymous Hemianopsia
Vision alteration from damage to optic chiasma	temporal or peripheral vision fields B
Vision alteration from ptic nerve damage	monocular blindness
Tunning for level to test vibration sense?	128 Hz
Number determines loss of protective sensation?	5.07 monofilament
All of these conditions are stemming from an issue with___? akinesia bradykinesia athetosis chorea hemiballismus rigidity Dystonia Tremor	basal ganglai
Gait speed < 0.4 is for	house
gait speed 0.4-0.8 is for	limited community ambulatory
gait speed >0.8	community ambulatory
NLI level	most caudal level w motor and sensory
Zone of partial preservation is only in what types	complete
Grief stages	Denial agression bargin Depression acceptance
neuropraxia def	myelin dysfunction reversible
axonotmesis	axon damage regeneration can occur
neurotmesis	axon, myelin, connective tissue component
anterior horn conditions	ALS Poliomyelitis
Neuromuscular junction conditions	myasthenia gravis
UMND characteristics and tests	Hyperactive atrophy no fascinations hypertonis ankle clonus babinski
LMND characteristics and tests?	decreased reflexes atrophy fasiculations hypotonic --> flaccid
parasympathetic roots are from?	cervical and lumbar
Sympathetic roots are from	thoracic
where is brocas area	frontal lobe
what does the frontal lobe do?	executive function voluntary movement personality emotions judgement
What does the parietal lobe do?	touch/sense proprioception pain sensaion temp
temporal lobe does?	auditory interpret emotions and actions
occipital lob controls	vision distance/demensions
white matter characteristics	in brain connects parts myelinated no dendrites projection and association fibers
Graymatter characteristics	unmyelinated neurons
Basal ganglia neuro diseases?	PD huntingtons touretts syndrome ADD obsesive compulsie
limbic system controls	mood emotion processing and store memory olfaction appetite emotional response to food
hippocampus is the?	memory indexer long temr memory
what does the amygdala do?	emotional processing fear pleasure arousal procesing of memory formation of emotional memory
Components of diencephalon?	thalmus hypothalmus epithalmus
What does the thalmus integrate sensory wise?	everything except smell to the cerebra cortex
What does the thalmus relay for the motor systme?	from cerebellum to precentral motor cortex
What does the hypothalmus integrate?	regulate hormones and maintain body homeostatis
What does the Epithalmus integrate?	olfactory (smell) pineal gland
What is thalmic pain?	spontaneous pain on contra side of body to leasion
Hypothalmus is off what issues can arrise?	obesity sexual disintrest poor temp control diabetes insipidus
What is the midbrain the relay station for.	cerebrum, cerebellum, SC
What makes up the brain stem?	midbrain pons medulla oblongota
Cerebellum damage creates symptoms on what side?	ipsilateral
what CN come off of the Pons?	middle 4
Pons regulates what?	Respiratrory rate orient head to vision and auditory
Medulla ablongotta Cn come off of it?	Last 4
medulla oblongotta regualtes?	RR HO somatosensation info for organs arousal and sleep
What reflexes are regulates by the medulla oblongotta?	Vomit cough sneeze
damage to the medulla oblongotta creates what side impairments?	contralateral
What part of the SC is gray matter?	Center anterior, lateral, posterio horns
What is controlled through the anterior horn?	efferent motor
What is controlled through the lateral horn?	motor thoracic and upper lubar ANS Preganglion
What is regulated through the posterior horn?	afferent sensory
where are the cell bodies and ganglions in the gray matter of the SC?	posterior horn
what makes up the ascending white matter tracts of the spinal cord?	Spinothalamic Spinocerebrall Dorsal column medial lemniscus
what is sent through the spinothalamic pathway?	pain temp pressure
lateral spinothalamic orientation of head to toe on SC?	cervical medial sacral outer/lateral
	ipsilateral sense of proprioception tension n muscles joint sense posture
What is sent in the dorsal column medial leminscus?	all the the other sense besides temp, pain, touch/pressure
Orientation of head to toe with dorsal column medial leminscus?	sacral medial cervical lateral
where are the axons in the SC?	white matter
Where does the spinothalamic pathway cross at?	SC
Where does the dorsal column medial lemniscal pathway cross at?	meduall oblongata
The lateral corticospinal ltract pyramid orintation from head to toe?	medial is cervical latera/outer sacral
Anterior cortical spinal tract of Pyramidal tracts that are descending control?	ipsilateral voluntary discrete & skilled movement
lateral cortical spinal tract of Pyramidal tracts that are descending control?	contralateral voluntary fine movements
Damage to lateral corticospinal tract shows?	+ babinski absent superfical abdominal reflex + cremastic reflex loss of fine motor and skilled voluntayr movement
Descending extra pyramidal tracts control?	grading of movements flexor withdrawl rflex
Damage to extra pyramidal descending tracts casues/	paralysis hypertonicity exaggerated DTR clasp knife reaction
Wish stroke recovery are synergies or spasticity seen at the beginning of recovery?	synergy
Right CVA characteristics	L sided impairments poor attention impaired awarenss and judgement spatial deficits memory deficits emotional lability impulsive
Left CVA characteristics	Right sided impairments increased frustration aphasia dysphagia motor apraxia language impairments
what aphasia should be treated w simple yes and not pharases?	non fluent brocas
what aphasia should eb treated w words and gestures and manual cues?	fluent aphasia
ACA CVA symptoms?	LE>UE incontinent apraxia bradykinesia motor inaction
MCA CVA symptoms?	UE>LE aphasia perceptual deficit HH sensory ataxia limb apraxia
Dominate side MCA CVA Symptoms?	aphasia brocas and wernickes
Non dominate side MCA CVA symptoms?	percetual: neglect, spadial disorganization
Major stroke invovles what artery and what symptoms?	internal corotid ACA and MCA but more MCA
PCA CVA symptoms of peripheral ?	occipital --> vision
PCA CVA symptoms of central?	Thalmus--> thaomus pain subthalmus --> involuntayr movement midbrain --> webers syndrome
What is webers syndrome?	ptosis (sagging eye lid) deviated eye
Vertebribasilar artery CVA types/locaitons?	superior cerebellar anterior inferior Posterior inferior cerebellar Artery (PICA)
Supeior cerebellar CVA symptoms?	movement coordination pain/tmep
Anterior inferior CVA symptoms?	Horners syndrome (pstosis, anhydrosis, myosis) PAM
PICA CVA Symptoms?	wallenberge syndrome -dysphagia ipsi face & contra body ptosis horseness pain
Webers syndrome cause?	Central PCA central PCA
Horners syndrome what? cause?	anterior inferior vertebropasialr artery CVA ptosis, anhydrois, myosis
Wallenberg syndrome what> cause?	PICA CVA ipsi face & contra body sensory ataxia dysarthria vomit nausea pain
levels of Rancho Los Amigos TBI scale	I --> X
what Racnho levles need total assist?	no response general response local respose I --> III
what Ranch TBI need max assist?	Confused aggitated confused inapproprite IV,V
what rancho level TBI need mod assist?	confused appopriate VI
what rancho level need min assist	automatic appropriate
What ranco level needs SBA?	purposeful approriate x2
What Rancho level needs mod I?	last purposeful appropiate
List rancho levels?	no response general response local resonse confused aggitted confused innapriparite confused approrpiate autopatic approriate puposeful approprite x3
What rancho level is it important to focus on structure?	confused inappropriate
when do past memories more than recent begin to show in rancho level for tbi?	confused approprite
What TBI rancho level is like a robot?	Automatic appropriate
what TBI level shows carryover fro new learning but intoleranct to stress?	first purposeful appropriate
what TBI level should you watch for depression and utilize to do lists?	2nd purp app
when can periodic periods of depression be seen and can multi task w breaks w TBI level?	last purp app
what TB level shoulde you shift between differnet tasks every 2 hours?	2nd purposeful appropiraite
list ASIA impairment scale names?	A complete B sensry incomplete C motor incomplete Dmotor incomplete E normal
What is the difference between ASIA C & D motor incomplete?	C MMT <3/5 D MMT > 3/5
spinal shock resolves in?	24 hours
Brown sequard MOI? S&S	stab/gun --> hemi section ipsi motor & contra pain & temp
Anterior cord syndroem MOI & SYS	hyperflexion motor corticospinal & spinothalamc Pain & tempt
Central cord Syndrome MOI & S&S/	hypertextension (stenosis & DJD) UE Motor and sensory loss LE varies
Posterior cord Syndrome MOI? S&S?	compression, tumor, alcohol syndrome loss dorsal column senses
Cauda Equinus injury S&S and outcome?	bowel bladder sex regneration possible due to LMN periph nerve
intercostal nerve roots?	T1-12
abdominal nerve roots?	T5-12
Cough above what level will be impaired?	T10
Vital capacity impaired at anythign above level of injury at?	T10
injury of what level affect bowel and bladder?	S2-4
bladder UMN impairment condition?	Reflexive empty when filled
Bladder LMN conditions and meaning?	Autonomous/nonreflexive flaccid bladder and need stimulous to empty
Autonomic dysreflexia occur aboe what levle? S&S?	T6 ^ BP, bradycaridia, pounding headache, flushing sweating, anxiety
what SCI level uses glossopharangyeal breathing to cough? what level uses manual assistance?	C4 C5
Startingat what SCI level can they cough independnelty and use manual WC at home??	C6
what level can do self LE ROM?	C7
what level can live at home alone except for heavy work?	C8
What SCI can walk w a walker?	T6-8
When are PD pts best do do PT?	morning after meds
what are the hoehn and Yahr PD stages?	1: uni involvmenet 2: B involvmeent no balnace issues 3: imapired righting reflex 4: severly disabling (walker) 5: confined to bed or WC
MS cause?	demyelination
when are MS pts best for PT	morning
Relapse remitting MS?	days to moths attac then full or partial recovery
Secondary progressive MS? life line?	relapse remitting but progressive 5-10 years
Primary Progressive MS? life span	Steady decline from onset not past 40
Progressive relapsing MS?	progressive from onset but clear exacerbations
Most common MS type?	relapse remitting
ALS/Lou Gehrigs disease involves what part of NS?	UMN & LMN & CNs
what has muscel weakness first w ALS?	hands
What 2 CN are responsible for Pupilary reflex and how?	II: optic sensory brings info in III: oculomotor constricts pupil N
CN affected by ALS?	5,7,9,10,12
lie expectancy of ALS?	2-5 years
Myesthenia Gravis disease type?	Autoimmune of motor end plates
What is the first S&S of MG?	eye lids
Muslce weakness moves in what direction and MG progresses/	Proximal to distal
GB is typically caused from____origi to the immune sysem?	viral
S&S of BG?	symmetrical distalto proximal LMN & CNs stocking glove
Recoveyr from GB can take up to ____w some impairments still.	1 year
Bells palsy affects what CN?	VII facial
what is post polio?	muscular dystrophy decades after initla polio
Post polio S&S?	Asymmetrical muscle weakness myalgia fatigeu decreased endurance
Tx of post polio?	orthotics low intensit endurane enercy concervaiton
Duchennes muscular Dustrophy cause?	genetic affecting males
Duchennes S&S	3-7 yo gowers sign scoliosis progress afte 11 yo
Charcot marie tooth disease causes and what is affected?	hereditiaty peroneal and distal eg (foot drp & stork foot deformitu)
TX of Charcot marie tooth?	orthotic for equinovarus deformity
vertigo lastin seconds is normally?	BPPV or TIA
Vertigo lasting hours is normally?	Meniers or stroke
Vertigo lasting days is normally?	vestibular neuritis/labyrinthitis TBI
H tests what CN?	3 oculomotor 4 trochlear 6 abducens
BPPV posterior canal test? Tx?	Dix hallpike EPly
BPPV horizontal canal test?TX?	roll test appiani
what outcoem measure is good to use w Vertigo?	DGI
EPly maneuver and lamperts/BBQ ROll which ear is being treated?	the one down or rotated towards
Dix hallpike test what eye are u testing and what direction will the eye beating go?	one that is down beats toward affected ear
Difficulty with smooth pursite and saccad are impairments with what?	CNS
dificulty w dynamit visual acuity means impairment with?	VOR vestib occular reflex
D2 motion?	Sward
D1 motion?	answering phone
What is Simian line (palmar crease) seen in?	downs syndrome
Erbs palsy affects what nerve roots?	C5-6
huntingtons MOI? prognosis/	degeneration and atrophy of basal ganglai death 15-20 years
S&S of huntingtons	mental deterioration speech disturbances ataxic gait
what type of rigidity is seen in parkinsons disease?	lead pipe or cog wheel cog wheel more common
Occulta myelomeningocele means?	incomplete fsion of vertebral arch no neurla tissue protuding
Meningocele myelomeningocele means?	incomplee fusion w neural tissue sticking out
Myelomeningocele myelomeningocele means?	incomplete fusion meninges sticking out spinal cord sticking out
when to contact a doctor when a seizure is happening?	time it and greater than 5 min
Types of seizures and symptoms?	Petite mal: "day dream" grnad mal: entire body